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Retin A and Acne– What Cleansers and Moisturizers Can I Use?

I got a great email from a 16 year old who is using Retin A micro for acne control. Like most of us, she got the prescription with little or no advice about how to use it. She wanted to know what scrubbing grains, toners and moisturizer I would recommend. She was concerned about the redness and peeling and wanted to avoid these problems with additional skin care products

Retin A was actually originally developed and approved for acne management. This vitamin A derivative helps the skin to empty pores clogged with debris, shuts down overactive oil glands and helps skin turnover to reduce discolorations from old acne eruptions. This process includes flaking off old dry keratin that is contributing to blocked pores and breakouts. Some peeling and flaking is necessary and actually good. However you need to keep it under control to avoid too much redness and irritation.

The solution is to allow Retin A to do what it does best. Twice a day use an extremely gentle oil-free cleanser such as Cetaphil Gentle Skin Cleanser and apply with damp cotton pads. Rinse off with handfuls of lukewarm water. Even a washcloth can be too rough in the first months of Retin A treatment Start by using Retin A every other night and gradually, over three weeks, work up to an every night routinue.

In the early months of using Retin A its very import ant to avoid additional irritants such as scrubbing grains or pads, toners and even alpha hydroxy acids ingredients such as glycolic acid. It certainly takes a leap of faith to abandon these tried and true acne aids and simply trust Retin A to clear your skin– but that’s the best way to succeed. These products and ingredients are simply too irritating to be used at the beginning of Retin A therapy and can make the skin so red and sore that people abandon Retin A treatment.

Using a moisturizer to control the peeling can actually lead to additional breakouts. If your skin becomes too irritated and flaky, use a tiny dab of oil-free moisturizer and take a two day Retin A holiday. In the morning make sure to use an light fragrance-free oil sunscreen such as Aveeno Ultra Calming Daily Moisturizer SPF 30. Retin A increases sensitivity to sun damage and its ESSENTIAL to use a sunscreen each and every day– even when its cloudy.

After six months, you skin will become comfortable, even bored with Retin A. At this point you can amp up the impact by adding exfoliators such as 3M Buf Puf Pads or my beloved Clarisonic cleanser. Toners and peels with glycolic acid can provide additional benefits for acne-prone skin. But if irritation and flaking reappear, cut back on the extras and focus on Retin A.

How interesting. There are some experts that it is the hormnes given to cows which links dairy products to acne. You can also try organic milk which is hormone-free. However if you acne is just on your cheeks, it might actually be a type of rosacea.

Wow! I’ve seen advices on reducing the number of diary products to prevent acne, but I didn’t know that this is because of hormones given to cows! I like various diary product and it’s hard to me totally give up today. But now I’ll definitely try organic milk. Good idea! Thanks.

In reality, no cow’s milk is dairy free. Even without the added hormones that are injected in the cows, they are still producing testosterone (an acne-causing hormone) at high rates because they are kept pregnant constantly to increase lactation. In short: even “organic” cow’s milk is still laden with hormones you don’t want in your body in excess.

Yes, you are absolutely right. If you really want to avoid these hormones, almond or hemp milk are good alternatives. I hesitate to recommend soy milk because it can be a problem for women with an increased risk of estrogen based breast cancers, but vegan milks provide wonderful nutrition. Nut based cheeses like cashew cheese are another way of getting dairy free nutrition. THank you for your comment.

YES–you should beware that there are natural hormones and hormone like substances in ALL dairy products. Think about it: cow’s milk (or any mammal’s milk) is designed to grow a small calf into an adult cow…quickly! Cow’s milk naturally contains proteins called Insulin Growth Factor 1 (or IGF-1) which is a hormone similar to insulin. Since acne is the result of overactive growth of skin cells (causing pores to clog) consuming a product that also increases cell growth only adds to the problem. And don’t expect your derm to know about how diet impacts your face. My derm had never even heard of IGF-1, but do a little google research and you’ll find a TON of scholarly research linking IGF to acne.

I’ve been using retin-a for about a month now and I haven’t experienced dryness, peeling or irritation and all I’m doing is using a light clinique moisturiser in the morning to enable my makeup to apply smoothly (something with spf if I’m going outside) and a facial soap morning and night. Is this a problem or am I lucky? I am noticing the inital breakout however.
Thank you for the informative post

Hi Martha,
Yes, your skin seems to be very comfortable with Retin A. To lessen the purge I would use an oil free sunscreen in the AM rather than a moisturizer which can be promoting breakouts. To help retin A fight acne a little better you could ask your doctor about adding a mild home glycolic peel or home microdermabrasion (eg CLarisonic). Let me know how you are doing.

I used tretinon and had a purge and got discouraged then started using movate creme which helped but now I want to start my retina but would you recommend generic or brand is there a big difference .. I am 24 years old and dealing with acne for 4 years now.

I had a bad experience with a generic Retin A that I bought online form Canada. I had much better success with generic retin A ( tretinoin) that I purchased in a NYC pharmacy. It was a bit more expensive ( $75) but it worked much better. However if retin A is prescribed for acne, it should be covered by insurance.

I’ve been on Retin-a for a month and a half now, I’ve finally started to notice a slight amelioration in my acne so I started using the Body Shop’s Tea Tree Oil line, which includes the Acne Clearing Facial Cleanser, the toner and the acne clearing lotion. I’ve noticed a lot of stinging and a few more blemishes have appeared. Should I stop using the body shops product if I want to continue using retin a?

Its sad but true but when using Retin A your choice of cleansers moisturizers and sunscreens are very limited. I would definately stop using all the products from the Body Shop and ask for a refund. I always recommend Sephora, CVS and Bath and BOdy Shop b/c they have a customer centered return policy. If the product does not work for you and you have saved your receit, they graciously return the money.
I would check out the list of skin care products in Product tab on No-Nonsense Beauty Blog Home Page. THese are all products that work well with Retin A.

Hi ,
Thank you for the blog. I use retin a 0.05% cream after my treatment with accutane to keep my skin clear. However, i suffered a minor breakout in the beginning which i was told was normal . It’s been just over 3 months with retin a and i seem to be getting backheads on my nose again. I don’t know what’s going on as retin a is supposed to PREVENT blackheads. I have added a glycolic scrub in the mornings and use a very light oil free non comedogenic moisturiser in the morning. I take diane 35 for the past 2 years and started antibiotics on my own account last month because i was worried i would get huge pimples again.
I don’t know what i could be doing wrong. I eat healthy, i live healthy. It’s so frustrating.
Do you have any advice? My derm appointment is in 2 months!!
Thank you!

You sound like you are doing fairly well, but new blackheads indicate that your skin is oiler. I would invest in micodermabrasion ( eg Clarisonic) and take extra time on your nose area. I would definately stop using the oil free moisturizer. Although they do not contain oil they can be a source of other ingredients that irritate and/or clog pores. Aldo make sure you follow a fat free diet and keep sugar and white flour intake under control. If oliness still continues add a glycolic toner in the oiler parts of your face. Let me know how things are going.

Hi, wow thank you for the prompt reply!
You’re right, I am getting oilier ever since I stopped accutane. I also seem to be getting oilier around that time of the month. I eat healthy and and have increased my salad and fruit intake. I was just wondering what should I do then if i stop using the moisturiser? I am so used to using after a year on accutane that I am worried i will break out again?
Thank you!

I am so glad I found this!
I was just prescribed tretinoin .025% cream on Monday and began using Tuesday for adult onset acne. I wasn’t given much direction either.
I never had acne in the past and all of a sudden I have hard core breakouts. It’s awful!
My doctor gold me that I can use a moisturizer after I apply the tretinoin to prevent flaking and over drying. I use an almond-aloe moisturizer from whole foods but it stings so badly! Was thinking if switching to whole foods cetaphil moisturizer knockoff. Also- I’m using Kate Somerville daily detox wash with my clarisonic twice a day (thinking of stopping this). I tone with witch hazel in the am. I remove my make up with virgin coconut oil which helps with dryness. Is there anything I should alter? My skin is super red and anything except the coconut oil burns.
Thanks again!

I think you just might be using too many products. To cleanse your face, lets just use Cetaphil ( the real thig) for sensitive skin. Cut back retin A to every other day and wait 30 minutes between the time you wash and dry your face and when you apply Retin A. You were on the right track with Clarisonic. I LOVE that little machine, but you should not use it for the first six months that you are starting Retin A. Stop using Kate Sommerville wash, witch hazel toner (which is mostly alcohol) and the almond aloe moisturizer ( which has enough oil to INCREASE breakouts). Try not using moisturizer at night for the first week on this new regimen. In the morning use Aveeno super sensitive moisturizer with feverfew ( very soothing) which also has an spd 30. Remenber Retin A makes the skin super sensitive to sun damage. Give this program a month. If you don’t see improvement, you may need hormonal therapy like Yasmin or Triphasal. Please keep in touch and tell me how things are going.

Thanks for your response! I used cetaphil for two days and it made my skin burn so much that I had to take it back. I cried when washing my face (without clarisonic) and when moisturizing. I’ve gone back to Kate Somerville and the aloe-almond moisturizer- my face no longer burns.
I’m only using the witch hazel in the am and it’s a non alcohol kind.
Why do you think my moisturizer will increase breakouts?
The moisturizer has SPF but I also mix in some ole herikson SPF 50 in with it in the am.
The flakiness has improved… I’ve been using some vitamin e for the super flakiness around my mouth.
Also- what should I do about pimples that erupt on their own? Should I apply the retin a on top? I skipped retin a last night and some of my white heads erupted as I was cleansing. I just dabbed the witch hazel on it- was afraid to use anything else. Advice?

Many of the producyts that you are using are working against each other and Retin A. Moisturizers and any similar lubricating products clog pores– and clogged pores are the start of pimples. If you are using the Cetaphil for sensitive skin and still are having problems while using Retin A I also think Retin A might not b right for you. Did you and anyone in your family have Rosacea. If so, Rein A is definately not for you. If you do have rosacea you need a different regimen and a specialized diet. I have seen this more than a dozen times in the last year and it suddenly became a source of my breakouts. The good news is the specific prescription medications like Metrogel are affordable and effective.

No one has rosacea in my family. I’ve stopped using the moisturizer on top of the retin a at night. It’s been better- nothing is burning, the moisturizer feels soothing. It’s so confusing what products will work and what won’t.
On some blogs I see that vitamin e is good, on others I read its not. I saw a blog that advised scrubbing all the dead skin flakes off- this seemed ridiculous to me. It’s so frustrating!
I’m purging but the pimples themselves seem different. Any advice on zits that erupt on their own? Thanks!

Hi, I’ve been using Retin A 0.05% at night & sunscreen during the day for 6-7 months now. My pimples had stopped appearing for a year, but have suddenly reappeared 3-4 weeks ago. There’s no lifestyle change/stress, etc. There are huge zits on my cheek, base of my nose & forehead. I consulted my dermatologist & he suggested that I use Clear gel in the morning post bath, continue using Retin A at night & Azithral 500mg once daily for 3 consecutive days in a week for 4 weeks. But the breakout seems to get worse. Help!

I know how awful it can be to do everything right and still get breakouts. If you are over 24, you might be dealing with hormonal acne– and the only treatment that works is a course of estrogen/progesterin pills like Yasmin or Triphasal. It worked for me and friends when everthing else including Retin A and Accutane failed. You should ask your OG/GYN or derrmatologist for a prescription. Please let me now how things are going for you.

I am 26 years old with a hispanic olive skin and have very large pores (thanks my genetic) on my nose and cheecks, some acne scars, and a lot of liitle hiperpigmentation spots which I thing were derivated from the pimples I had when teenager, and a lot of blackheads on my nose however pimples are not comon any more only in my period time. I have a have been using Retin A 0.05% for 3 weeks now, on the first 2 weeks I was appliyng every second day, no peeling what so ever, now in the third week I am using everyday, it has been 4 days in a roll I am using it and my sking is super irritated, red and peelling a lot, the suncreen loreal 50FPS seeems to make my skin super oily, what is the other sunscreen you recomend?. I will definetely stop Retin A for a couple of days and get back when its better, my question is, when should I stop Retin A? 2 months, 6 months or when I get the results? I also bought from Skin Laboratory 2 “do at home peels”, one is the Glycolac (25%Glicolic + 35% Lactic) and the other is a HQ+ This peel contains salicylic acid, lactic acid and resorcinol, I bought them to try to heal my hiperpigmentation and also acne scars, open pores and oily skin issues. I am planning to wait another 3 weeks to star using it, glicolac first once a week for 4 weeks and then HQ+ once every 2 weeks as it is peel grade 4 peel. What do you think about this skin routine??

Hi Elen,
I am just finishing up a big post with a super smart doctor on Retin A and acne. Give me a week and I will be able to provide the most up-to-date answers to your questions. In the meantime, don’t use the peel yet. I will be getting names of moisturizers and sunscrrens that will make things better not worse.

i am rimon ,i am just a problem in acne,and why not it s not going properly,abut i am sixten the first time its breakout now i am 19 but there is not going,i am use retin a 0,05% before two month,at first now my sceen is so much dry,so u can tell me,what can i do that now

Hi Rimon,
Doctors now believe that RetinA alone is not going to get acne under control. You also need to use an oral antibiotic, a combination of benzoyl peroxide and clindimycin during the day. Use a mile cleanser to wash your face and an oil free sunscreen. If Retin A makes your skin too dry, use it every other night rather than every night.

I am also having an issue and I’m using Trention every night. My skin is really broken out and it’s also peeling. The breakouts tend to be much worse the week leading up to my menstrual cycle. I do also have the benzoyl peroxide and clindimycin during the day. I am going to try using the Cetaphil sensitive skin wash along with the Aveen Super Sensitive moisturizer with feverfew as I see that is recommended for peeling. I have some acne scarring too. Is there any suggestions for that? Also some suggestions as to why I keep having these horrible breakouts??

You are using the current gold standard for acne care. If this combo has not shown a huge reduction in eruptions after three months, then you probably have hormonal acne. This need to be treated with birth control pills and/or spironolactone ( which decreases androgens) used singly of in combination with each other. Please try to make an appointment with a dermatologist that is associated with a medical center. If you tell me where you live, I can check with the Woman’s Dermatology Society to find a great doctor in your area. I will be doing a feature on acne scars which may give you needed info.

Hi. I’m 20 years old. Being a teenager I never suffered from acne. But during the last year, I started getting acne but in a very mild form like one or two pimples before my period. But then I started wearing makeup, which resulted in clogged pores and I also suffered from discoloration due to sun damage. My doctor prescribed me to use Tretinoin (0.5mg) to help with uneven skin tone. I have been using it for every night for the past 3 weeks now. My skin is dry and extremely sensitive. At first, I experienced peeling and drying, but I kept on using it because i wanted my skin to get used to it. I havent been using any cleanser just olive oil to remove any makeup and a moisturizer. I wear 50+ suncreen in the morning. My skin is so dry that no amount of moisturizer helps and so much so, my skin is becoming more sensitive because of thinning caused by tretinoin. I’m worried that at such young age, my skin is becoming so thin that I can no longer put anything on my face. Should I continue it?

I suggest that you cut back to using Retin A just twice a week– eg every three days. You can buy without a prescription a benzoyl proxide cream which can be used every morning. I also suggest using microfiber cloths that with just waterr remove dirt and make-up with irritating the skin.

Hi..im 25 years old with extreamly oily skin.ive recently started using Tretinon for about 10 days now and my pimples have almost cleared up…i dont have any dry red irritated skin nor flakiness…is my skin immune to tretinon or just a use a stronger amount.at the moment im using a 0.25% ointment .Do i apply just on my pimples or all over my face?im confused..also since my prescriptions for 2months ,do i apply the tretinon everyday for 2 months or only when i break out??……thank you!

Hi Nina, It sound like you are getting excellent results. Current guidelines recommend that you spread a pea size dab all over the face at night, especially in the areas where the breakouts occur. I’m also a little confused about your preseciption. Theusual tube lasts at least six months when used as directed, so I wonder if you are using a sample size.

Exactly right. Your doctor knows what they are doing. Adding benzoyl peroxide in the morning as well as doxy during the day attacks acne on all fronts. You are the poster child for a well designed anti-acne program. Just be sure you are using an oil-free zinc oxide sunscreen since Retin A makes you skin super sensitive to the sun.

Hi I started using treinoid .1% in December 2012 weekly/nightly (expect for saturday and sunday) till about early May 2013 when I saw that me skin was very raw and red even as I tried to use it 3 times a day, changed to a heavier moisturizer and am using it again most of this month. Would you recommend a better cleanser than Cetaphil? I have used the gel for normal to oily skin while off of it and found that my skin was very dry after; I also used the one for sensitive skin and found that it was equally drying when I was on it and off the cream. Plus I find that neither of the Cetaphil remove makeup and I end up have to use remover wipes to which all make my skin red. Or since I don’t want to use cetaphil what ingridients should I avoid in cleansers? I am in my very early 20s and use the cream for acne.

I was recently prescribed Tretinoin .025% for my adult onset acne. I noticed in previous postings you mention benzyol peroxide is ok to use with RetinA (Tretinoin), I’ve seen conflicting information that benzyol peroxide negates the effects of RetinA – could you please clarify?

You cannot use benzoyl peroxide at the same time as you apply Retin A. Benzoyl proxide is used in the morning, covered by a sunscreen. At night you can use Retin A. Please let me know if you need additional info.

SO happy to have found this but want to ask you a few questions. I was prescribed Eupido but have not used yet. I use dermalogica ultracalming wash, multi active toner, the everyday scrub, and the smoothing moisturizer (its the second lightest one) I am going to start using the retin a (eupido) once every 3 three days and bump it up over the next month. Am I using the right products? I have the cetaphil cleanser and their sunscreen I use if I know I am going out at all but honestly my skin has been so bad I don’t leave the house. I have never had breakouts before and I am 28 now. I got on birth control to help, I do not take any other meds but fish oils. I eat very clean (paleo) no dairy and no carbs, I watch my sugar intake and drink copious amounts of water. I am at a lost. I have a clarisonic and just got a new head for it – the sensitive one. Should I be using that everyday or start slow especially with using the retin a? And, wash face, wait 30 mins, retin a, wait 30 mins, moisturizer? Like that? And no toner correct? Please any help would be amazing.

Using Retin A means changing most of the products that are used for cleaning and protecting the skin and this inclludes CLarisonic, toners, and scrubs. I have an extensive free guide to Retin A that you can download if you like my Facebook page. I detail all the steps and products that are recommended. Recent guidelines from the American Academy of Dermatology recommend using Retin A at night and a benzoyl peroxide and clindimycin gel in the morning for successful acne control. Some dermatologists even perscribe additional antibiotics for three months. If this regimen does not clear the skin in three months its likely that you have hormonal acne and need estrogen therapy to deal with breakouts. One last thought. If you are using Retin for acne, I recommend Liquid Neutrogena cleanser and SkinCeutuical physicial defense for sunprotection. The other products are too rich in oils where acne is a problem.

I have been using Retin A .05% cream on my face for four days now. I bought Trader Joe’s tea tree oil face wash thinking it would be gentle. But it kind of stings and burns a bit? I have no severe dryness with Retin A. No peeling. The face wash makes my face drier than the Retin A. I use a gentle moisturizer with sunscreen as well. This is my regimen:

THere is a reason that I have a very small recommended list of products to use with Retin A. When you are using it for acne, best cleanser is Liquid Neutrogena. Most commerical products contain too many and irritating ingredients to use with Retin A. And again, I never recommend using any moisturizer when Retin A is used for acne and I told you to avoid Clarisonic when starting Retin A. I would suggest stopping Retin A for a week and clean as directed, using just clindamycin as directed during the day. Then start again with the program I outlined before. You need to use it as directed for three months to give it a chance. Let me know how things aer going after a month.

Hi there
So i recently bought the retinol 0.5 by skin ceuticals. I have been on accutane 2x approx 2-3 years ago. I started retinol 4 days ago and have used it every night as i still get mild acne and have alot of hyperpigmentation. My skin is already showing so many improvements and feels so smooth! However i have not had any rashes, dry skin, peeling or stinging in these 4 days from applying it every night, despite everywhere stating to begin with using it only a few times a week. Is it still working even though im not getting any side effects yet? is there a possibility i will develop dry skin later? I thought the whole point of retinol was to remove the dead skin? Im slightly worried that i cant see my skin peeling ( even though that sounds weird! ) let me know! thanks!

Retinol is much milder than the lowest levels of true Retin A so you would not see redness or peeling. Skinceuticals is one of the few effective retinols, and you can get good results without irritation.

I have been using Retin A for about a month now and I have no flakiness or peeling. Breakouts have cleared up. I’m using dove soap–very gentle, and in the morning I use sunscreen. If I’m not peeling and turning red is it not working?

First I need to know the name and concentration of the form of Retin A you are using. Also can you tell me how yu obtained the Retin . I’ve received numerous emails from people who bought Retin A without a prescription that does not seem to be doing anything. The fact that you are clearing up is a very good sign.

Hi. My son has pretty severe acne with hyperpigmentation. He just started tretinoin and doxy 100 mg. he uses organic shea butter soap with tea tree to wash with night and morning. I bought him the oil free cetaphil moisturizer with spf of 50 to use in the mornings but we havent used it yet. Im not on facebook. Is there a better sunscreen i can buy since you say not to use moisturizer? I have the neutrogena for acne sunscreen but it seems to make his acne worse.

If your sun have severe acne there is absolutely no need for a moisturizer. However a sunscreen is important if he is using Retin A. THe best one, recommended to me by Dr Tina Alster, the laser expert, is Physical Fusion UV Defense SPF50 from SkinCeuticals. It is the only sunscreen I have found that ca be used for oily or acne troubled skin. There two versions– tinted and clear. Itis broad spectrum and made with zinc oxide rather than chemical sunscreens. Let me know how it works for you.

I am seventeen and i was prescribed retinA .04% for my acne. I was on doxycicline 100mg before but is it ok if i continue taking that pill as well as
applying retinA at night? Also, I haven’t seen any results as far as clearer skin, its just been dry. How long until I should notice results?

Combining Retin A and an antibiotic is a great duo and can prevent the surge of acne that can happen with Retin A.You should see significant benefits in three months. lets me know how things are going.

I am 23 and using .005% Retin A for my cystic acne. My doctor prescribed it when the antibiotics I was taking didn’t work. I can’t tell if it’s working yet. I’m kind of a hypochondriac, and I overanalyze my skin (psychological effect of acne). I’m starting to notice fine lines around my eyes when I smile. When I stop smiling they are very very faint, but are still there. Am I wrinkling already? Is this common at 23? Will Retin A work for these small fine lines as well? I admit to only drinking coffee, never water. But I am a sunscreen-aholic , never tanned, my parents aged beautifully, and I always wear shades. Could it be dehydration? Is it reversible?

Tiny lines round the eyes at your age is usually due to squinting or frowning. Doctors report that girls as young as 15 in Texas get little crow’s feet because the very bright sunlight mkes them squint. It can also be due to overuse of drying products used for acne. Cystic acne often responds best to hormonal treatments, so if the Retin A does not work, go back to your doctor and ask him about Ortho Tricyclin.

I use tretinoin .05% at nighr in combination with minocycline 100 m 2x per day… also I use low-ogestrel birth control pill which was prescribed by a different doctor prior to the mino… however the new doc was informed about the use of the BC before he prescribed it… I hate to question his advice but is there any way the BC and minocycline can be working against each other? Its been 3 weeks with no improvement however I’ve been using cetaphil oil control moisturizer for acne prone skin which is probably the cause… I will stop using that asap. Also I use dove soap the bottle kind twice a day should I stay with that or switch to the bar form?

Actually minicycline and Retin A work very well togeher and are often subscribed together for better results. However I would switch to Cetaphil cleanser for oily skin and eliminate any moisturizer entirely. Don’t forget to use an oil free zinc based sunscreen in the morning because Retin A makes your skin more sensitive to the sun. You might might to add benzoyl peroxide cream in the morning before the sunscreen for a little more acne fighting power. Three weeks is a pretty short time to see big results. Give the regimen up to three months to work.

I’ve been using tretinoin 0.1% (Stieva-A Forte by Stiefel) for acne about 18 weeks now.. My skin improved so much that people started to give me compliments about how my great my skin looks now from before. flaking and dryness was not really an issue for me as my skin tend to be oily and tolerant to the medication. At around week 10 of treatment i began using hydroquinone 3% (generic) morning and night together with my nightly tretinoin cream to deal with dark spots from previous pimple scars. My skin cleared and the complexion of my face became significantly even with just a few minor pimples and redness on my chin, probably from shaving. I finished my hydroquinone tube within 6 weeks and decided to take a break from using it as i’ve read from other blogs that continuous usage is not advised. my skin looked and felt great until about a week ago when i started to have major breakouts. until now pimples are still erupting on my chin, cheeks, and forehead. my skin care routine hasn’t change much since i started treating myself (i can buy tretinoin without prescription in my country). Cetaphil cleanser morning and night, Neutrogena sunscreen spf50 in am, facial scrub once a week, Neutrogena hydroboost water gel occassionally only in am, tretinoin only at night every night since week 4. had my skin become more sensitive? should i change or add any product? should i reduce the frequency of tretinoin application? or even switch to a lower dosage? Any advice is very much welcome. I would really want to keep the results i had as I had pimples and acne since my early teens. i’m 28 btw and male. my pores still look big, my skin is still oily and still have blackheads on my nose but i’m kinda used to it anyway..

The standard treatment for acne can also include antibiotics both orally and in a gel, and a benzoyl peroxide gel. Use the Retin A and antibiotic at night and the benzoyl peroxide in the morning topped by a sunscreen. You might be experiencing “the purge” which is very common with Retin A. Since you tolorate Retin A so well, Uou might also step up your cleanser to something sronger like Neutrogena Acne Wash. If the skin gets too dry you can cut back Retin A to every other night. Let me know how things are going.

Why is so important to not use a mousterizer when using retain a ? What is the difference when using just sunscreen? I am using retain a 0.025% just at night. Also 1% clindamyacin lotion. I generally use arbonne face wash at night and benzoyl in the morning.

Most moisturizers, even those that are oil-free contain ingredients that can irritate the skin and trigger more acne. Sun protection is essential and its worth the time and effort to find a sunscreen that dones’t make your skin break out. They often have lighter formulations that won’t clog pores. Studies have shown that more than 50% of acne in women over 25 is due to cosmetic products. Your triple combination of retin a, clindamycin and benzoyl peroxide reflects current treatment guidelines. Best cleansers are mild and oil free too. How are you doing?

I used to prescribe Cetaphil moisturizers and cleansers to my patients on isotretinoin or Retin A products. These products are gentle and nurturing for those who are already on an aggressive acne plan. Avene makes great products for those suffering from dry sensitized skin as well…. the line is just a bit more pricey.

Does overuse of Retin A cause the orange peel texture? I’m on 0.05% Retin A from my doctor, and I use it nightly, with Eryacne (twice a day). I’ve been using this for a month and haven’t experienced very bad side effects apart from a bit of flaking which quickly went away. Maybe it’s cos’ I had oily skin to begin with and live in a tropical and humid climate.

However, about a couple of weeks ago, I notice I’m suddenly getting this rough orange peel texture on one cheek though that area has been moderately clear. I didn’t even get this when I had pimples. I did some googling, and brought up results about how some people experienced it too and that it is attributed to topical treatments for acne. What is your opinion on this? Should I cut down my usage of retin A?

Hmm, that’s interesting. Orange peel skin is due to the breakdown of collagen under the skin and what you see is a lack of support for the skin architecture. From a strictly scientific point of view, because Retin a encourages new collagen growth, it should reduce orange peel skin, not create it. I will ask my experts their opinion and get back to you.

Thanks! I look forward to your response! I’m puzzled too as I’ve also read that Retin-A is supposed to do good stuff like smoothen the skin and such, so I can’t imagine why it’d do that to my skin.

I was also wondering if it might be because I used too much (I’m pretty heavy handed with application of creams, but now I make sure I only put a thin layer), or that my skin is too dry? I’m not using moisturiser because my doctor advised against it. If I feel dry or itchy, I just spray some mist.

Please please help! I’m so anxious-I have been using Retin A for two months now, and today I had to work outside for a few long hours. I only had some SPF 15 and SPF 30. I know they don’t add up but I used a good amount of them both and kept reapplying throughout the day. I wore a large sunhat and glasses, and still came home with a moderate sunburn. I know, had I not been on Retin A I most likely would not have gotten burned. I’m super paranoid about the “Retin A sunburns cause skin damage to the nth degree…” is there any redemption for my skin?!

What a coincidence. I found myself in the same situation today. If the sunburn is on your body as well as your face, an oatmeal bath will reduce the inflammation. If its just on the face, I would drink two glasses of iced gree tea and use the cooled tea bags as facial packs on the skin. Green tea has been shown to be the most protective antioxidant UV damage. And FYI you can’t add up the SPF’s. The level of proection you get is the highest number you are using. In your case this would be SPF30. I would look for a 50SPF such as the new CereVe sun sunscreen or the Physical Defense from SkinCeuticals. If it just happened once, you can repair the damage. Its the long term exposure that causes problems. My tea bags are now cool, so I am going to lie down and plop them on my face.

Hello,
I’m 35 years old and developed hyperpigmentation when I was 27 on my upper cheeks below the eye area. I’m going to start using Hydroquinoe (twice a day) and Retin A (once every other day). What are the best cleansers to use? I noticed alot of articles mention using oil free moisturizers and cleansers; my skin is a lot dryer now; if I use products for dry skin will it interfere with the meds?
Thank you

Unless you already have significant sun damage, its a little early to start using Retin A. You body is still able to easily repair itself. Insead I would be sure to do a weekly glycolic mask and daily 50SPF sunscreen. And I thik its wonderful that you are thinking ahead!

Thanks for the urgent reply. What would be the right age then that I can use Retin-a? Right now, I have already fine lines in my forehead but its less visible I think. Then I have blackheads in my nose. If it is early, So I will try to use Loreal Revitalift. Do you have an idea if this is effective as anti-aging cream? Or can you suggest an effective anti-aging cream?

Retin A may improve shallow acne scars and discoloration but it may not deal with significant problems. To help you use Retin a without redness and irritation you can download my free guide to Retin A if you like my Facebook page. Tak e a look at it and just email me if you hve additional questions.

hi.. i resumed using hydroquinone for 1 week now.. this time it is 3% hydroquinone combined with 0.025% tretinoin in one tube from a generic brand.. i still use the same products and routine. i noticed that my skin is not as red as when i used .1%. my pimples also dry up quicker. would it be a good idea if i would stick to 0.025% instead of 0.1% tret? would it still be effective in controlling my pimples even at a lower percent? i’m planning to maintain my daily application of tretinoin and my 8 weeks on and 8 weeks off hydroquinone cycle for the rest of my life as anti aging regimen. can u comment on this? thanks. of course i do take extra precautiona against sun exposure. wide brimmed hats are my signature accessories now.

also. you suggested to me neutrogena acne wash. i’m somewhat reluctant about that because its active ingredient is salycilic acid which is a beta hydroxy acid (BHA). other blogs warn against using BHA products with tretinoin.

thanks. i also have concerns about hydroquinone. it is banned in the US and other countries. i have a natural south east asian tan skin. i dont want to bleach it, i just like to even out the dark spots from the pimples. and i like the healthy glow that hydroquinone gives. A dermatologist friend suggested arbutin instead but i’ve read that it metabolizes into hydroquinone once it is absorbed in the skin. so they’re just the same thing. My other options include Niacinamide and Vit C but it is difficult for me to get good quality products. kojic acid is also common here but since i’m on tretinoin, it might be too irritating. i am actually concerned with dull complexion and age spots more than wrinkles as i would age inevitably. if longterm tretinoin use can correct and prevent uneven skin pigmentation as well then i won’t use other lighteners anymore. my new job involves meeting people on a daily basis so looking healthy would greatly help. BTW lancome has this “color corrector” product but i can’t find reliable reviews about this aside from the promotional ones. don’t know if its really effective or just a waste of money.

hi im using RetinA for the last 7months and now i starting to breakout really badly.i use t Retin A only at night as was instructed to twice a day i used eucerin scrub and in the day i use the eucerin hydtrating lotion.I have may holes after starting Retin A and also my skin texture is terrible the acne has become worse.WHAT CAN I DO?

Hmm. lets see what we can do. First of all, Retin A is used only at night because it makes the skin photo-sensitive. Use an acne cleanser with salicylic acid like Neutrogena Acne Wsh. Then I would STOP using moisturizers, since this can be provoking breakout problems. Since you will be using Retin A only once a day, your skin will not be so dry. Retin A can cause a prge of pimples, but this usually happens at the beginning of treatment. I would ask you docor for gel that contains both an antibiotic and benzoyl peroxide. This attacks breakouts from another angle. Make sure you use an oil free sunscreen in the morning to avoid sundamage which enlarges pores. Let me know how things are going.

Conventional therapy recommends avoiding scrubs whe using RetinA. I would switch to Neutrogena Acne wash which has salicylic acid and would be less irritating. During the day make sure you use a strong oil free suscreen to protect your skin.

Hi! I just started Retin A Micro 0.04. I was prescribed it for mild acne but am hoping it will help with anti-aging as well. (I’m 32). I am already washing with Cetaphil, but I’m really unsure of what moisturizer I should go for. Any suggestions? I currently use the Clinique moisture-surge gel. I have the SPF 50 oil free city block for during the day (if I go out at all, I’m a stay at home mum). Also, will there be a point for me to jump to 0.1 of the RAM? Thank you so much for your time.

You’re on the right track. Studies have shown that women who used Retin for acne hen they were wrong, developed fewer wrinkles as they got older. When starting Retin A for acne, I would recommend using Neurogena Acne wash and a very light oil free moisturizer. Moisture Surge Gel may be too rich for skin that is prone to breakouts. Your 50 SPF is PERFECT. I suggest using up the entire first tube of Retin A. If you skin does well you can then upgrade to the .1%, starting every other night to avoid irritation.

Hi. I’ve been using retina for about two 1/2 months now. I was told that my acne would get worse and then it would go away like magic. I’ve also been using the benzoyal wash every other day and my own cleanser twice a day. I use the retina every night before bed. In the first month my acne was getting better. I got a little dry but never redness, peeling, itching I. Was told id get. But the past couple weeks, my acne exploded. I’ve gotten pimples where I normally wouldn’t. I can’t remember the last time I had a pimple on my chin and that’s where most are now. I just want t o know is this around the time it gets worse before it gets betteror am I just not one who got lucky enough with the retina?

You are experiencing what is known as “the purge”. Its awful and one of the reasons that patients don’t renew their first Retin A prescription. It can be better controlled if you are also on oral antibiotics and use topical antibiotic products like clindimycin and topical benzoyl peroxide. In a wash, this helpful ingredient is on the skin for too short a time. I would also suggest using Neutrogena acne wash which has salicylic acid, another acne fighter. Ask your doctor for prescriptions for a three month course of antibiotics as well as a clindimycin and benzoyl peroxide gel. Give this complete therapy three months. If you skin is not yet clear, you may have hormonal acne and eed to be treated for that. Let me know how things are working out.

I am 32 years old and suffered with severe cystic acne in my teens. I was put on Accutane for a year. It completely cleared my acne but I was left with some scars. I have recently stopped birth control ( don’t need it anymore as my family is complete) and I have broken out again with acne and cystic acne. The cystic acne is on my face (mostly chin area) and is even on and in my ears. I have been prescribed retin a 0.05 and I am using it once every three days right now until my skin gets accustomed to it. Two questions…what skin cleanser, toner and lotion would you recommend. I normally am a bit sensitive in the cheek area. And two, what foundation would u recommend. I have been thinking about bare minerals as it is powder based. I do need the foundation due to the uneven colouring in my skin. Much thanks. Btw, I was on Orthodox tricyclin.

I generally like Avene products but I have not tried this cleanser. It really depends if you are using Retin A for acne or anti-aging. You want a very mild cleanser like Cetaphil if you are over 30 and using Retin Ato deal with pigmentation and lines. A slightly stronger cleanser line Acne Wash by Neuutrogena could be a better choice if you are having breakouts. However many dermatologists start all their Retin A patients on a Cetsphil like forumla and then move up to a stronger product. If you already have the Avene product already, you can certainly try it out and see how your skin reacts. And for more info, you can download the free guide to Retin A on my site.

I used Retin A for 4 years prior and stopped using for a year. I started using Retina (0.05%) again. I mix the retina with Obagi blender cream. I noticed the skin around my mouth started breaking out. I stopped using Retina and used cortisone to help the healing. Has anyone had this experience? I would like to continue using the retina without the blender cream. Can I use the retina by itself? Is there a cream I can pickup in the drug store that I can mix with the retina?

The answer depends on why you are using Retin A. If you are using it for acne you ned to use it with other medications like benzoyl peroxide and antibiotic gels. The Obagi blender cream is 4% hydroquinone which is used for lightening dark patches and spots. If this cream is causing break outs, I would stop using it. The combination of hydroquinone and Retin A is effective for this type of pigmentation, but if it causes problems, then its not for you. To get benefits without additional problems you might want to try Triluma which is a prescription only balanced combo of Retin A, hydroquinone and steroid. I’ve never of breakout problems from Triluma.

I got off birth control nuvaring after being on it for over 2 years and started breaking out like never before I’m now using tretinoin gel 0.01% every night and cleanse my face with dermalogica special.cleansing gel and light active moist moisterizer day and night i also use been using benzoyl peroxide 10% as a spot treatment during the day . And cephalexin 500mg anabiotic daily as well. my skin is still breaking out though i feel little cysts underneath my skin and the next day it comes to the surface than dries out but than more come again my skin is peeling allot and not sure what else to do anymore. Do you have any advice? thanks you in advance

Hi Vanessa,
If this has gone on for more than three months it really sounds like you have hormnal acne and to go back on birth control peels to contol the breakouts. Hormonal acne begins so deep in the body that topical medications like benzoyl peroxide and even oral antibiotics will not bring it under control. Your doctor may aslo want to add an oral form of tretinoin to really get the acne process under control. The longer the breakouts continue the greater the chance for developing scars and irregular pigmentation.

Hi,
I have been using Tretinoin Cream, 0.1% for wrinkles around my eyes and around my mouth. Would you recommend what moisture and face wash I should be using? My dermatologist sold me NEOVA DNA Total Repair and Glycoilix 10% moisturinzing cleanser. But, the more I’ve read online, most people use something I can just buy at the store. I feel like my dermatologist just wanted me to buy his expensive products. What do you recommend? About once a week I use a facial scrub, thinking it might help with flaking. Thanks

Hi Nancy,
With a few exceptions, I tend not to buy any products that are sold by a dermatologist. And you are absolutely right that less expensive ( and better) products can be found in your local drug store. For cleansing when using Retin A, my number 1 pick is Cetaphil Facial Cleanser ( about $10) and to moisturize at night, I recommend CeraVe PM moisturizer. It has BOTH ceramides and hyaluronic acid which are natural moisturizing agents. Cost is about $12. I was surprised ( and disappointed) that your dermatologist did not supply you with the most important skin care item when you are using Retin A– a good sunscreen. I recommend SkinCeuticals Physical Fusion UV Defense SPF50. This product is available thru a physician, in Blue Mercury Stores or online. IMO it is the best sunscreen that does a great job of sunprotection and is non-irritating. Be very careful when using Retin A near your eyes. You should not put it at the corners of the eyes or under the delicate eye tissue. Only combination Retin A products like Triluma can be used in those areas.

Thank you for responding. Oh wow, I have serious crows feet around my eyes and sagging wrinkles under my eyes. So you don’t recommend using the Tretinoin Cream there? I will ask my dermatologist about a prescription for the Triluma. I have serious peeling/flaking around my mouth since I have sun bathed regularly and perspire there and do not keep on the sunscreen over the years. So I guess that’s the peeling going on. I have noticed the peeling around my eyes too, but not as bad. I have been thinking of having microdermabrasion to eliminate some of the peeling. What are you thoughts on that? I will get the cleanser and moisturizer you recommend. Thank you for all the advise.

Oops, you recommend ceraVe PM at night. Do i use it with retona, before, after? Won’t that delute the retina? What about a moisturizer for AM after washing my face, that’s when I flake the most? Thanks!

Hi Deb,
Ive been on tretinoin for about 7 months now (.25%). I use it every night after i wash my face. I still get major redness & flakey skin. Do you recommend any moisturizers or sunscreens? I currently use l’oreals 30 SPH oil free sunscreen but think it’s causing me to break out. Any suggestions would be appreciated!

I have been using rentin-A for a little over a year and I still find I get break outs is it safe to add a toner with salicylic acid into my routine and use it at night right after I use a gentle cleanser? I would, of course, use a moisturizer too. Can I use the rentin-A (0.01%) one night and an extra spot treatment with salicylic acid the next day until the breakout clears?

First I would stop using moisturizer! The oils, waxes and/or emulsifiers can block pores and trigger more breakouts. I would use a mild cleanser like Cetaphil foaming cleanser or if your skin is still oily you can use a cleanser with salicylic acid like Neutrogena acne wash. You can also use benzoyl peroxide in the morning and an antibiotic gel like clindimycin at night. Just use it right on top of the retin A. Make certain that youse an oil free mineral sunscreen in the morning. Let me know how things work out.

hi!! I’ve been using retacnyl 0.025% together with glycolic acid 12 in the morning and 15 at night for a over 3 months and I noticed my skin texture looking waxy orange peelish and my pores still look open esp when I tilt my head to the light. I upgraded to 0.05% for about 1 month and I still do not see much difference in the bad texture! Should I continue using retacnyl? Why do I have that bad texture?

I’ve been on 3 courses of retin A, I’m coming up to 20 years old and I’m a female. I’m not allowed anymore retin A as it could harm my body apparently. Retin a worked everytime but about 6 months later the spots would come back! The spots have come back and I was wondering if you knew any products that could help maintain the unblocked pores etc? Clensers and toners, anything! My skin is incredibly oily so I wake up everyday with a new set of spots on my face it’s disgusting! Thank you for your really helpful blog post.

Hi Hannah,
I think you would be a great candidate for hormonal acne treatment. I actually like it much better than Retin A for acne. Ortho Tricyclin is a single daily prescription pill that stabilizes the hormones that are driving the excess oiliness and subsequent breakouts. Ask your dermatologist or gynocologist to prescribe it. WHile on the pill you can use standard anti-acne cleansing and topical products to help things along. You can download my brand new free guide to acne if you subscribe to No-Nonsense Beauty Blog at the pink bar on the top of the page.

Hi Deb, I’m 30′ and concern about my skin, I use RetinA 0.5 for over 5 months and it works for me the only thing I don’t know how to use this product along with other skin care products my Neutrogena Fresh Foaming Cleanser /makeup remover and Neutrogena Toner.
Today went shopping and got this Neutrogena products , and CVS brand Oil Free Mousterizer Spf 15. I don’t know how to combine all of them at night (except the Mousterizer Spf 15, which i only gonna use it for daytime) and if I need a extra night cream along with RetinA.
I just hope all this product brand works for me , seems that non of them has alchohol . Plus I was thinking to buy Estee Lauder daytime Mousterizer and maybe nightime Mousterizer too. I already used today afternoon the combination of my Estee Lauder foundation for the first time with Ceraphil Mousterizer but made my skin sticky and shiny, I already have oily skin which made my skin feel so uncomfortable and heavy.
And another concern that I have is if I can apply my RetinA on my undereye as a eye crem for the night to smooth out my fine lines.
if u have any suggestions please I’m ready to hear it.

Hi Joe,
I am so glad that retin A is working for you. I like your choice of Neutrogena cleansers. However I am concerned that you are overusing moisturizers. If you have oily skin, moisturizers will make it worse and trigger breakouts. I’m also concerned that the toner can be too irritating with retin A. What you do need is an oil free sunscreen because retina makes your skin extra vulnerable to sun damage. I recently published a free guide to acne care that you can download when you subscribe to the blog. It should answer most of your questions.
Finally, Retin A cannot be used On the under eye area.

I’ve been using Retin A for about 3 weeks now. I started using it all wrong! I was prescribed to use Neutrogena Acne wash in the morning, Acanya gel, and then a moisturizer. For at night, I was prescribed Pan Oxyl face wash, Rentin A, and then the same moisturizer.

It took me about a week to buy the nighttime face wash, so I was using the Neutrogena (with salicylic acid) in the morning and night. That was a big mistake! So, I stopped doing that, and noticed less dryness.

I have had a ton of redness and severe dryness on my chin since the beginning. So I stopped putting any gel (Acanya or Retin A) on my chin, and haven’t put any on it for about 5 days now. But my chin’s redness hasn’t reduced at all!

I am using CeraVe moisturizer and have been applying it very liberally to my chin, but it’s still very red and unsightly looking.

I just want to know what I can do to reduce this redness and dryness on my chin, especially since I have stopped applying any topical gel to the area.

I was prescribed tretinon 0.025 for slight acne and also for discoloration. After reading the reviews I am scared to try it because I don’t want to break out bad; since I am not a severe acne person. Also the not finding the right moisturizer and sunscreen as well I question.

If you have mild acne I too would hesitate to use Retin A. I would recommend a less aggressive treatment as described in my guide to acne care-which you can download when you subscribe to my blog. If you have a problem with breakouts I would moisturizers since even oil free formulations can clog pores and trigger pimples. However I would use a daily sunscreen to prevent aging as well as help with discolorations. Hope this helps!

I have been on ziana with benzoyl peroxide, tazorac, cetaphil, as well as oral antibiotics. My dermatologist says I may or may not break out. But after evaluating and the meds I have tried she thinks this would be best. My face will be clear one week and then the next acne.

I’ve been using Retin A 0.025 for about a month now. I’ve also been using the Cetaphil cleanser that my dermatologist recommended. So far the results are that the acne on my forehead and the acne, plus some dark spots, on my chin area have for the most part went away. Although, since using retin a I have noticed that I’ve actually gained a bit of acne on my cheeks, mostly my left cheek, and my right cheek not so much. But, my left cheek has been looking better lately. My concern is what sunscreen (and moisturizer if necessary) can i use if I start to go swimming this summer that will protect the acne on my face since, a) I have just actually started to see progress in my face so I don’t want to mess it up and, b) I just started to use Retin A a month ago , and c) Since I heard that the chlorine in pools can be REALLY REALLY REALLY REALLY harmful!

It sounds like retin a is working for you. the outbreak on your cheeks could be what is known as the “purge” when the skin gets a bit worse before it gets better.
Since you use retin a at night, using an oil free mineral sunscreen will offer great protection. Chlorine actually kills bacteria and is an ingredient in some excellent anti-acne products. So you don’t have to worry about additional problems.

That’s a relief! Thank you! Are there any specific brands of oil free mineral sunscreens that you would personally recommend for me?
It’s also probably worth mentioning that I live in the Sunshine State.

So happy to have stumbled upon your blog! I am starting Retin A Micro and have been taking an oral antibiotic twice a day to help fight acne. I have never had problems with acne until after I turned 25. At 26, it decided to hit me with a vengeance. Oily skin, deep pimples that take forever to heal, and hard white balls coming out of my poors. My questions with the Retin A Micro are 1) what type of moisturizer would you suggest trying first? 2) what type of daily sunscreen? 3) I recently purchased a Clarisonic and I LOVE IT. What type of cleanser would you recommend?

Appreciate the advice in advance. Trying to minimize the number of products I buy and then ditch. Derm didn’t give much instruction!

Hi Sarah,
Iam glad you found me too. I think you can find the answers to your questions in my free guide to acne that you can download when you subscribe to my blog. If you have additional questions, just let me know. Best, deb
PS June is Acne Awareness Month and I am doing a round up of new treatment options for acne that I think you will find interesting.

I’ve been on retin-a for 2 months now and need a new wash routine. I am mostly dealing with oily skin and blackheads. My blackheads can’t seem to go away, and my face gets super oily. Hence, I never got the side-effect of peeling or dry skin. I use Neutrogena Oil-Free Wash 2-3 times a day depending if I work-out in the mid-day. I have a very strict diet of low carbs and med-fats. I also use a prescribed lotion by my dermatologist called “clindamycin phosphate topical lotion” every morning. Also, I’ve noticed that my laugh lines on the corner of my nose seem to be getting redder and drier; causing them to be oily. They were never like this before I started Retin-A. I heard that Retin-A is suppose to work for wrinkles, but it damages my laugh lines.

Most treatment plans do not recommend washing the skin more than twice a day. There is a new cleanser for acne prone/ oily skin. It’s called Cln and you can get it online. Like the Neutrogena acne wash it’s got salicylic acid but at much lower concentration. However it’s got chlorine like ingredient that kills skin bacteria. Even better it’s phalate and fragrance free. It’s my new go-to cleanser, and Trying out products is my job. I would also suggest avoiding the areas that are red when applying Retin A. Let me know how things are going. Best, deb

I am 32 years old and I am considering to use retin-A to minimize brown acne scars and also to improve sun- damage and discoloration marks. Every winter I use meladerm on my face which I found to be a great product to reduce my freackles and lighten my face, however, I also did notice that Meladerm takes a long time to produce the expected results. At the moment, my freckles are very light and so what still bothers me is a couple of brown acne marks that I have on my face. Will the Retin A help me with that? Also, can I use retin A with meladerm and which dosage should I use? My skin is oily and I do get the occasional whitepimple marks on my face, but it is nothing too major. I do use sunscreen every day since I was 15 years old, at the moment I have been using the nakedbee moisturizer with SPF30 under my make up. Also, could I apply the retin-a only on the brown spots and not to my whole face to minimize skin reactions? Thanks.

Hi Vivian,
Rather than just Retin A I would use a combination of hydroquinone, a mild steroid and Retin A called Triluma to erase the dark spots and patches. It is used for three months at a time, followed by just Retin A for the next three months. This regimen will work much more effectively when you are focused on pigmentation rather than acne or aging. You then won’t need Meladerm whichseems not to be working that well but should cotinue with the sunscreen. FYI Triluma is available only by prescription.

I was looking into hydroquinona some time ago and it made me concerned that there are some studies that show that it could potentially increase risks of skin cancer (though I know its has not been proved). Also, I have also read that hydroquinona helps to reduce freackles melasma, however, iwhen the skin is exposed to the sun they will grow all over again, is that right? That happened with my meladerm. I do take precautions when I am in the sun, but I do have freackles and they do grow a lot in summer months, no matter what I do. Regarding the retin-A, do you think i should start with 0.025% or do you think that I can use the 0.05% since the beggining? I do understand that I need to apply every second or third day in the begging and that I only have to use a small amount, I have used retinoic acid before to treat strech marks. Last question, is there a difference between the retin-A brand and its gemerics, such as A ret or retino-a?